We aim to critically evaluate existing literature on transoral endoscopic parathyroidectomy via the vestibular approach (TOEPVA) - a remote-access technique developed to eliminate visible cervical scarring in the management of primary hyperparathyroidism (pHPT) while preserving optimal cure rates. This systematic review evaluates the safety, efficacy and operative outcomes of TOEPVA.
✦ The floor
Discussion
Signed responses from readers of the wire.
No actionable change for audiologists — TOEPVA is a parathyroid surgery technique with no direct audiology or hearing-related clinical implication.
TOEPVA represents a scar-free surgical alternative for parathyroid disease, but its relevance to the audiology field is negligible unless monitoring post-surgical calcium levels that could affect neuromuscular hearing function.
- 01Systematic review and meta-analysis evaluating TOEPVA (transoral endoscopic parathyroidectomy via vestibular approach).
- 02Assessed safety, efficacy, and feasibility across multiple existing studies.
- 03TOEPVA avoids neck incisions by using small cuts inside the mouth.
- 04Parathyroid glands regulate calcium, which can have neuromuscular implications.
- 05No audiology-specific outcomes were evaluated in this review.
TOEPVA is a safe, efficacious, and feasible approach for parathyroid removal.
studypartially supported- PMID
- 42615428
- DOI
- 10.1308/rcsann.2026.0084.
- Journal
- Annals of the Royal College of Surgeons of England
- Publication type
- meta_analysis
- Evidence level
- 1a
- Population
- Patients undergoing transoral endoscopic parathyroidectomy via the vestibular approach (TOEPVA)
- Intervention
- Transoral endoscopic parathyroidectomy via the vestibular approach (TOEPVA)
Primary outcomes
Safety; Efficacy; Feasibility